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Review supports long-term effects of antipsychotics for schizophrenia

A review conducted by experts in the field found little evidence of negative long-term effects of antipsychotics for schizophrenia and indicated significant efficacy for acute psychosis treatment and prevention of relapse.

“The evidence from randomized clinical trials and neuroimaging studies overwhelmingly suggests that the majority of patients with schizophrenia benefit from antipsychotic treatment, both in the initial presentation of the disease and for longer-term maintenance to prevent relapse,” study researcher Jeffrey A. Lieberman, MD, of Columbia University and New York State Psychiatric Institute, said in a press release.

Jeffrey A. Lieberman

The recommendation that all individuals with recent schizophrenia receive acute and maintenance antipsychotic treatment was recently challenged by concerns that antipsychotics may negatively affect long-term outcomes.

To address these concerns, an international group of experts in antipsychotic pharmacology, neuroimaging and neuropathology was convened. The group reviewed clinical and basic research findings about the potential adverse effects of antipsychotics on long-term outcomes.

There was little evidence of negative long-term effects of initial or maintenance antipsychotic treatment on outcomes, compared with withholding treatment.

Randomized controlled trials indicated significant efficacy of antipsychotics for acute treatment or psychosis and relapse prevention.

Correlational findings suggested that early intervention may reduce duration of untreated psychosis and improve long-term outcomes.

“Existing clinical evidence for a negative long-term effect of initial or maintenance antipsychotic treatment is not compelling. Patients and their families should be made aware of the strong evidence supporting antipsychotic efficacy and of the side effects that vary between drugs,” the researchers wrote. “Additional research is needed to help quantify the risk-benefit ratio associated with continuation compared with discontinuation of antipsychotic treatment and to identify predictive biomarkers in order to facilitate shared decision making and a personalized medicine approach.” – by Amanda Oldt

Disclosure: Lieberman reports no relevant financial disclosures. Please see the study for a full list of relevant financial disclosures.